Critical Reviews in Oral Biology & Medicine, Vol 9, 345-361, Copyright © 1998 by International & American Associations for Dental Research
Oral splints: the crutches for temporomandibular disorders and bruxism?
T. T. Dao and G. J. Lavigne
Faculty of Dentistry, University of Toronto, Ontario, Canada.
Despite the extensive use of oral splints in the treatment of
temporomandibular disorders (TMD) and bruxism, their mechanisms of action
remain controversial Various hypotheses have been proposed to explain their
apparent efficacy (i.e., true therapeutic value), including the
repositioning of condyle and/or the articular disc, reduction in the
electromyographic activity of the masticatory muscles, modification of the
patient's "harmful" oral behavior, and changes in the patient's occlusion.
Following a comprehensive review of the literature, it is concluded that
any of these theories is either poor or inconsistent, while the issue of
true efficacy for oral splints remains unsettled. However, the results of a
controlled clinical trial lend support to the effectiveness (i.e., the
patient's appreciation of the positive changes which are perceived to have
occurred during the trial) of the stabilizing splint in the control of
myofascial pain. In light of the data supporting their effectiveness but
not their efficacy, oral splints should be used as an adjunct for pain
management rather than a definitive treatment. For sleep bruxism, it is
prudent to limit their use as a habit management aid and to prevent/limit
dental damage potentially induced by the disorder. Future research should
study the natural history and etiologies of TMD and bruxism, so that
specific treatments for these disorders can be developed.
